Cervicovaginal Microbiota and Metabolomic Profiles in Pregnant Women With and Without Short Cervix

In this study, we aimed to investigate the cervicovaginal microbiota and metabolic profiles in pregnant women with a short cervix and assess their role in cervical shortening and the risk of spontaneous preterm birth (sPTB). To our knowledge, this is one of the first studies to simultaneously analyze both microbial and metabolic factors in relation to cervical length in this high-risk group. We conducted a prospective case-control study with 36 singleton pregnancies between 16 and 20 weeks of gestation. Our findings revealed significant dysbiosis in the cervicovaginal microbiota of women with a short cervix, characterized by increased Ureaplasma and decreased Lactobacillus. Additionally, metabolomic analysis showed significant alterations in the arachidonic acid pathway, with elevated levels of 13,14-dihydro-15-ketoprostaglandin A2, which were positively correlated with Ureaplasma abundance. These results suggest that microbiota dysbiosis and metabolic disturbances may play a crucial role in the development of cervical shortening and sPTB. Our study provides valuable insights into the molecular mechanisms underlying a short cervix and its progression to preterm birth, highlighting potential biomarkers and therapeutic targets for early intervention. These findings have important clinical implications, particularly in identifying women at risk for preterm birth and improving outcomes in this high-risk population.